I am a 4th-year BSN student , and part of our OB clinical experience was to follow an OB/GYN last week. It was a horrible experience.
First, I was put in a room with 3rd-year med students, which was great because I introduced myself and got to chat with them about their program.
Then I waited over an hour for someone to acknowledge me. (I was escorted to the room, so it was known I was present). Other nursing students did this same thing through the semester, so it's not like I was the first one.
Finally, the MD came in. We all stood up, and he introduced himself, shook hands with the med students, and ignored me. I was very upset by this, so I forced my hand out at him and introduced myself.
Then the MD told some H&P about a patient, mocked them with the door open, called out individually to med students to follow him-and did not provide me directions. So, I made the best of it and knocked on patients' doors, introduced myself, and asked if I could observe the visit. This allowed me time to talk to patients and get information.
Then the docs walked in, did their exams, and left.
I know how to measure a fundus, use a Doppler, and take H&P. Whoopie! I was pregnant before, so this was not an educational experience for me.
Also, I was very insulted by the MD's attitude. He is supposed to be a professional. He made it quite clear I was not welcome-even before he met me. He was also unprepared. He told every patient he had no idea what labs were drawn, what the results were, or what meds they were taking. I could not imagine this person as my MD!
For the first time since I was in nursing school, I felt out of place, insulted, and even embarrassed to be in the nursing field. After that clinical visit, I found out that other students were treated this way. I made a complaint to my instructor and received no feedback.
I am sure not all doctors are like this, but I recommend reading The Intern Blues instead of following some jerk around if you want to know what doctors do. As for them knowing about what nurses do, they don't care as long as they don't have to do it.
 |
|
|||||||||||
 |
||
search realityrn
sign up for weekly cartoons, tips, and blog posts
Register to win a pair of RX Medical Silver Fox Crocs
|
|
|
 |
February 14th, 2009 at 11:22 am
Are the described demeaning behavior, gross insensitivity, insolence and contemptuous rudeness signs of a sadistic personality or are you just slightly paranoid ? I have no idea. But it does appear that you dislike (hate ?) this man and, in this case, your objectivity is in question. It would be nice to read some comments from a third person present during your “ordeal.”
February 14th, 2009 at 11:55 am
It sounds like you had a bad experience, but by your own admission you tried to make the best of it. I had a similar OB-GYN rotation day, and I did the same thing as you – I knocked on exam room doors, introduced myself, asked questions, and observed. Then, I did it all over again with another patient. I don’t know what your feelings are towards this particular doctor, and while I wouldn’t go so far as to suggest that you’re slightly paranoid, I will say this – it always helps to give someone the benefit of the doubt. Just because you were led to a waiting room doesn’t mean that this particular doctor was informed of your presence. He may have had no idea why you were there. You might say that after introducing yourself he should have just assumed that it was his responsibility to take you under his wing and educate you, but I don’t know that that’s the case. His primary educational role is towards the pre-med students, not the nurses. Your clinical faculty may be at fault here – perhaps they should have sent someone along to introduce you and clear the way. You say that several other students had a similar experience. Perhaps your school needs to do some re-education with this particular clinic in order to determine what the educational experience of the students should be. I’m speaking to you as a nurse, but also as someone who has a lot of physicians in the family. Physicians are human – they make mistakes, they get incredibly busy, and yes, sometimes they rub you the wrong way. The exact same thing can be said of nurses. As for the MD not knowing what labs were drawn, what the results were, or what meds they were on, well, I can’t really address that since I don’t know what kind of clinic it was. If it’s a CHC where lots of different women walk in and out all the time, and where physicians rotate patients, then it makes sense that he wouldn’t know that information. Perhaps what the physician should have done was to say “I don’t know, but I’ll find out”. Perhaps why he didn’t know is because the office staff did poor prep work of the chart. I really don’t know. I just know that unless doctors and nurses give one another the benefit of the doubt from time to time, then things can get really tense. If you were to work with this MD on a daily basis and saw this behavior continue, then it’s worth saying something. It sounds more like your school needs to step in, re-evaluate and re-discuss the nursing students’ experiences and expectations with this clinic, and move on from there.
February 14th, 2009 at 12:55 pm
I can empathize with this situation as I have experienced the same treatment as a BScN studnet. It takes many kinds of people to make this world go round… do not let this individual leave a bad taste in your mouth. One day EVERYONE has to answer for their behavior and I truly believe what goes around comes around. Good for you for having enough dignity for yourself and taking the initiative to introuduce yourself and meet the clients. In response to Joseph (M.D.) I question your objectivity? I did not hear “hate” or even dislike for this individual. What I read, was concern for the inappropriate behavior… common courtesy for another human being… like saying hello, welcome to the group, shaking a hand. Just because we as nurses do not have M.D. behind our name does not mean that it is grounds to treat another person as less than human… nor does mean that M.D.’s are superior. How’s that for objectivity Mr. M.D. maybe you should take a look in the mirror.
February 14th, 2009 at 12:59 pm
I am a former nursing instructor, and I am appalled that nursing students are required to “follow” a physician for part of their OB experience. Nursing is a discrete and autonomous discipline and I cannot imagine why, in a program as intensive and time-constrained as an ADN or BSN program, this would be seen as an academically sound use of time, even without the “hour” of just sitting there waiting to be acknowledged. There is so much of value we have had to take out of curricula already that the remaining curriculum must be as enriching as humanly possible. A physician is not a nurse, has not graduated from nursing school, does not hold a nursing licence, and does not practice nursing any more than a nurse is a physician. One doesn’t learn to be an apple hanging around in an orange grove! A far better way of teaching nursing students about other disciplines is to engage in collaborative, multidisciplinary rounds or, better, clinics, as recommended by the IOM.
Dr. Neuschatz sounds quite defensive in his post, but I can hasten to assure him that indeed most if not all of us nursing school alumni could share similar horror stories regarding arrogant and demeaning physician behaviour. I hope the defensiveness in his post belies a professional who cannot fathom his colleagues engaging in such behaviour and not someone so completely blind to the dynamic as to be complicit to it.
Whitney Price, MS, RN
February 14th, 2009 at 1:43 pm
I appreciate your opinions about me Ms. Price. I did practice “defensive medicine” (check my novel “terrO.R.” if you have the time), but otherwise, I am never defensive.
Here is my new idea: is it permissible (in a web page named “RealityRN”) to remove this story from the medical field and place it in the human one ?
Everybody has bad days: taxi drivers, husbands,
wives, doctors, nurses and, believe me, even supermarket cashiers!!
BEST,
JJN
February 15th, 2009 at 10:02 am
I’ve found that the overly paternal, “Daddy, may I” activity you describe is more common in smaller, community facilities. An interesting look in the development of physicians is “The House of God” by Samuel Shem.
In fairness to the doc (in limited aspects), he could have been encouraging the med students to have taken a pre-emptive strike, and reading the patients’ charts before rounds, thus providing him with lab results, H&Ps, etc. He does have a job to do, and you were an unexpected bonus (obviously not perceived that way). Most MDs I have worked with in a university setting are more than happy to teach- from nursing students to EMT students doing their ER time. If something interesting comes in, I make sure the doc lets me know.
Finally, the attendings at my facility know better than to piss off the nurses, and some of the residents had to learn the hard way. One resident put in a triple lumen catheter in the ER, and when the nurse told him he had left a mess, the resident informed the nurse, “Cleaning up is YOUR job.” Word got back to the attending, who told him to clean his own mess up. Subsequently, every little thing the nurses do as a courtesy and a matter of course became “Technically, that’s a doctor’s order, and doing ____ without an order is practicing medicine without a license, and that’s YOUR job,” such as ordering Tylenol for an obviously febrile patient, ordering routine labs, filling out lab and radiology requests, starting IVs, etc. After several days, the resident complained to the nurse manager, who told him technically the nurses were correct, and asked point blank, “Who’d you piss off?”
It followed him to every unit he went to during his residency.
Don’t stand for that kind of behavior. As a student, you should defer to your instructor, but as a licensed RN, you have to defend yourself, and at times, your profession. Another excellent book to read is “25 Things Nurses Do To Self-Destruct” by Laura Gasparis Vonfrolio.
February 15th, 2009 at 5:06 pm
I am afraid that this doctor did know we were coming to observe. My week was the fifth one of the semester and we were not the only nursing school that made visits. Other students from my class expereinced this same treatment too. When I asked one student how her visit was last Wednesday, she said, “not as bad as the others” so maybe because we took it upon ourselves to be interested in what the doctor was doing instead of just following along and looking at the clock, that could have changed his attitude about us. It’s very possible past nursing studnets were rude or disinterested.
I am a very open minded person, and it is possible this physician had a bad day as Dr. Neuschatz suggests or had a rude student. I know not all Doctors act this way and I should have remembered that he allowed us to interrupt his day. Thank you Dr. as Dr. Neuschatz for bringing up this point and letting me see the other-side of the situation.
It’s also fair to say that while following RN’s I have also experienced similar behavior (like being left out of change of shift report on my patient that I am supposed to be taking care of, or not givin any information while observing, etc.).
I guess I was disappointed about the whole thing and did not see the big picture. I guess that’s what learning is all about.
February 15th, 2009 at 10:05 pm
i completely concur with the nursing instructor Whitney Price. Ive never heard of a nursing student being put with an attending and med students. I would make sure your clinical coordinator get this feedback from nursing students or at least you- you should be with a nursing clinical instructor or other nurses to learn what nurses do, not be put in the position you were. How awkward.
February 15th, 2009 at 11:40 pm
Joanna,
Eons ago the Latins used to say: “Errare humanum est, perseverare diabolicum.”
Thank you for your comments.
JJN
February 16th, 2009 at 7:10 pm
While we are a separate and autonomous discipline, I think there is a place for learning from our physician co-workers. Yes, I say co-workers because I believe we are a team and only through good working relationships with our physician partners can we truly give the best care to patients.
However, this might not be the best choice for a physician teacher. I have met many physicians who are truly skilled at educating and have a passion for teaching others – no matter what their “title” may be. These are the types of physicians I would rather see nurse interns with – where there is a real opportunity for learning to occur.
Aside from any biased perspectives, this doctor may not be the best choice for leading such a learning opportunity with the nurses in this program. Just don’t shut the door on other potential learning experiences with physicians because of this man’s poor example and/or behavior. There are many great physician leaders out there who are more than willing to share their knowledge and help others who are interested in learning. It just takes a little work / time to find the right combination! Hang in there, I hope your next experience is a much more positive one!
February 17th, 2009 at 6:58 pm
I had a physician mock me while he had 4 medical students with him. I had asked if perhaps we could give lasix to a man who was very edematous. He asked if he could call me at home if it messed up his kidneys, if it didn’t work, if it made him worse, etc. I said, “No.” He questioned why I’d ask for something but not take responsibility for it (basically saying, “I’m the doctor, I make med suggestions. If you aren’t willing to be called in the middle of the night for med-related questions, don’t suggest meds.”) I said, “If you don’t think lasix is a good choice, then let’s not use it. What else can help?” I was blushing, I know, but I wasn’t about to back down and sneak off. He wrote the order and said, “It might help.” I was so angry. In the ICU, nurses are supposed to offer suggestions for things we need — we spend 12 hrs with them, the dr sees them for 2 minutes.
Later, he was joking with me. When I joked back and the medical students laughed at my joke, not his, THAT made him mad!
I’m irritated that he’s setting a bad example for the students. He shouldn’t mock me. I guess I just need to set a good example for them, too, which is a strong nurse who knows what’s going on with her patients, cares about them, and communicates concerns with the physician.
February 18th, 2009 at 12:07 am
I know what you mean! We are the ones on the front lines with the patients and the doctors think that since we didn’t attend med school that we don’t know what the hell is going on. In the SNF I work at, we have a doctor that doesn’t like to return pages when he is on call. I’ve gotten to the point that I pretty much “stalker call” him until he calls back. Then when he finally does, he gets mad and yells at us for no reason. I had finally had enough of this and confronted him one day when he made rounds. He didn’t like it but I had to say what everyone was thinking but was apparently to afraid to say. He still takes his sweet ass time calling us back but he hasn’t gotten rude with me since that day. He still gives a little hell to other nurses there but I’ve let them know to grow a spine and stand up to him. Why do doctors think they are so much better than we are??
February 25th, 2009 at 1:29 am
I have had sort of similar experiences during my EMT clinicals and nursing clinicals. The standing by and waiting to be noticed was common. During my EMT clinicals in the ER I was blessed that the Medical Director came around. He looked at me and asked are you going to jump in or be a wall flower like the others? I must have gave him a puzzled look and he said to make my education what I want it to be and be more proactive. I jumped in…the next trauma rolled in and the pt. came in with full cardiac arrest. The CNA was asked to continue CPR and the Med. Director looked at me and smiled so I jumped in and asked if I could. The rest of the day was magic. The staff saw me as someone who really did want to learn something that day.
When my nursing clinicals rolled around I never hesitated to jump in and at least ask if I may “do it”. This included the dirty jobs as well as the cool ones. After awhile, the staff realized I didn’t want to be a wallflower, that I wanted learn and eventually sought me out for new experiences. This included doctors and it was reflected on my evaluations. It was scary at first to assert my right to learn but done with finesse, I was able to get the education experience I wanted.
Just my experiences….
September 29th, 2009 at 8:30 am
not too sure why you’re following the doctor around. As his role as a mentor is to the medical students and not to you, he doesn’t have to want you around. In instances like this it’s hit or miss whether the doctor will be nice to you.
I’m really quite unsure as to why/how you ended up under the supervision of the doctor and not a nurse.
September 29th, 2009 at 3:36 pm
I truly feel for your experience. And, I can relate. You’ve worked very hard to get where you are at, and it is never a nice thing when you feel snubbed. But, it happens and will happen.
What is wonderful is that you took responsibility for your own education. More than anything, this will show your clinical educators that you will be a very good nurse.
My only suggestion is that if this happens again and you are left behind, maybe it would be helpful to find another nurse there to follow and learn from. Find someone who really likes students.
All the best,
Kisha
September 30th, 2009 at 11:06 am
Joseph J. Neuschatz M.D – what you do not realize, perhaps, is that by your very comments you support the concept that physicians are arrogant, apternalistic, and use superiority as a primary defense mechanism. Thank you for illustrating so very well the idea that physicians are not operating (pun intended) in the best ways possible for patient needs but rather to support physician ego gratification.
September 30th, 2009 at 5:08 pm
well, every time I read stories about nurses being treated badly by physicians I must say that really nurses must stand up for themselves. Really, it is nurses fault, I do not understand why any nurse will let any doctor to disrespect her, only one time somebody disrespect me I would really nicely let him know that. Trust me it will stop immediately, Today we have courst and public is on nurses’s side. There is no need to accept any bad behavior. Nurses are very highly trained professional their education is more difficult than any psychology or business curriculum. Please nurses stop it. Stand up for yourself. This will never end, it is 21st century, nurses are not maids, so stop behaving like one.
August 31st, 2012 at 4:32 am
Hi there,I’m a current BSN stnduet. It all depends on what you came into the program with.For example- I am missing some libs, which isn’t part of my curriculum- so although they’re included in my tuition, I have to do them on my own time- whether its evening classes, summer or online.So far, I have had to do two evening classes in one semester, and this summer I did 2 online courses. Some days are long, so don’t bet on having time to do courses during the day. The best bet is to get everything done ahead of time.It also depends on how your school is set up- mine is set up so with each semester you get more clinical hours- so its easier to take such courses in the beginning vs the end, when you are do final placements that are basically full time work hours.